Monitorização Terapêutica e Manejo de Aminoglicosídeos baseado em PK/PD: Uma revisão de escopo
DOI:
https://doi.org/10.55892/jrg.v9i20.3159Palabras clave:
aminoglicosídeos, monitorização terapêutica de medicamentos, farmacocinética, farmacodinâmica, amicacinaResumen
O presente estudo tem como objetivo sintetizar as evidências disponíveis acerca da monitorização terapêutica de aminoglicosídeos e do ajuste terapêutico baseado em princípios de PK/PD. Foi realizada uma revisão de escopo com busca sistemática, alinhada às recomendações do Joanna Briggs Institute para revisões de escopo e às recomendações do PRISMA-ScR. Os descritores e seus sinônimos foram pesquisados em português, inglês e espanhol nas bases de dados PubMed e LILACS. Foram identificados 1001 registros e, ao final, 14 artigos foram incluídos. Os artigos incluídos foram majoritariamente observacionais, com predominância de delineamentos retrospectivos. A monitorização terapêutica dos aminoglicosídeos foi realizada principalmente por estratégias de coleta no pico/vale. As avaliações de eficácia foram, em sua maioria, baseadas em Cmáx/MIC, com uma parcela menor dos estudos citando também AUC/MIC. A segurança foi estabelecida, em geral, por meio de metas para Cmín. As evidências sistematizadas nesta revisão destacam a necessidade urgente de padronização das métricas de eficácia e segurança empregadas na monitorização de aminoglicosídeos. Nesse cenário, a Monitorização Terapêutica baseada em princípios PK/PD emerge como ferramenta potencialmente relevante para otimizar o uso de aminoglicosídeos, especialmente em populações críticas, nas quais a variabilidade farmacocinética é substancial.
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